My babies are anemic. Need advice!

[ShanaV]

I found out the other night that my babies are anemic and I'm worried that my doc will tell us to do something ridiculous like give them formula or rice cereal. They are EBF and I worked SO HARD to get them to this point I'm not going to give it up. Tell me about iron in breastmilk. Tips?

[babygirlie]

He would probably just give him a vitamin. They have these medicine pacifiers where you can just put what is needed in it and they suck it out. At early ages you can put a little milk in there and they slurp it before realizing. That's what I did anyway. I didn't give them a whole bottle with that nasty (I'm assuming) tasting stuff. There did come a point where she spit it back out at me and I stopped giving it to her because it stains and well...

[poorlittlefish]

Yes, I am sure they will just have you give them some vitamins. That is what mine did.  No big deal.

[HappyMonkey]

i just read yesterday that the third trimester is important for iron stores being transferred over to the baby (also blood from the placenta if you delay cord clamping). So it's probably a factor of their early birth, not something you are doing, or wrong with your breastmilk.

I'm sure you'll get lots of ideas.. good luck.

[Asiago]

 A bit of research and some more questions to your health care practioner may be prudent to be sure the diagnosis is accurate. I would definitely question it a bit before administering iron.

http://www.kellymom.com/nutrition/vitamins/iron.html

http://thebabybond.com/Iron%20Supplements.html

Edited by Asiago - 12/19/10 at 9:42am

[coyotemist]

Floradix is a natural iron supplement!

[PatioGardener]

Originally Posted by coyotemist 

Floradix is a natural iron supplement!

And great one for kids/adults, but I would not give it to babies under a year because of its honey content. 

[dharmabum]

I would up my own iron intake.  Floradix is great and if you are eating iron rich foods, then eat something high in Vit C along with it--makes the iron more absorbable.  Are you feeding them solids yet?

[tanyalynn]

Originally Posted by ShanaV 

I found out the other night that my babies are anemic and I'm worried that my doc will tell us to do something ridiculous like give them formula or rice cereal. They are EBF and I worked SO HARD to get them to this point I'm not going to give it up. Tell me about iron in breastmilk. Tips?

Babies born early are at higher risk of iron deficient anemia just due to when more iron is normally transferred from you to them. 

If you're not iron deficient, then supplementing yourself a) would not be good for you, since iron's one of the easier-to-overdo minerals, and b) wouldn't change the amount in your milk.  It's held fairly steady unless you're already low--it doesn't go up and down with your intake the way, say, some B vitamins or vitamin C will.  Most minerals are held fairly steady in breastmilk, though there are a couple exceptions.

I don't know what supp would be best for a baby--but I'd do a supplement rather than formula or rice cereal.  Honestly, I'm willing to supplement nutrients to my kids, there are quite a few ways to get low and IMO it's better to correct, even synthetically, than not (though I'd consider the supp the pediatrician recommended but still look around to see if something better exists). 

[ShanaV]

My doc just called me and said to give them the iron vitamins, so we're g2g. They'll have to gve blood again after taking the vites for a week to recheck, which sucks to have to do, but it's ok. Thx for all the tips, ladies!

[PatioGardener]

Before checking again, make sure that a week is enough time to make a difference.  I'd hate to see them get poked twice!  I know when I had low iron the recheck was after 6-8 weeks (can't quite remember, but much longer than 1 week.)

Good to hear that nobody suggested formula or rice cereal! 

[GuavaGirl]

ShanaV:  just curious... is iron testing a standard test at a certain age, or were there symptoms that prompted the test?

[Llyra]

Around here, the peds typically offer iron testing at about a year old, along with the lead screen.

[Courtney-Ostaff]

Breastmilk doesn't contain iron, so about 6 months of age, EBF babies start to get anemic.  Of course, usually then babies start eating solids, so it's not a terrible issue, but it's SOP for good pediatricians to check on it, just in case.

[PatioGardener]

Originally Posted by Courtney-Ostaff 

Breastmilk doesn't contain iron, so about 6 months of age, EBF babies start to get anemic.  Of course, usually then babies start eating solids, so it's not a terrible issue, but it's SOP for good pediatricians to check on it, just in case.

Actually, breastmilk does contain iron, just not very much.  But the amazing thing about breastmilk is that the iron it contains is really easy for the body to use, unlike other iron sources which are not as 'bioavailable'.  Once babies start to eat solids (and cow milk in particular) their ability to absorb the breastmilk iron decreases, so starting solids that are naturally high in iron is a good idea.  My little guy started with sweet potato at 7 months, but I am not worried about his iron, as my levels were fine in pregnancy, and I delayed his cord clamping until the cord had stopped pulsing (about 15 minutes).

Breastfeeding, and in particular, exclusive breastfeeding, has very little to do with anemia, and very very few term EBF babies start to get anemia at 6 months.  Which is awesome, or we probably would not have evolves as far as we have as humans!  In fact, it is now thought that anemia in infants has more to do with mother's iron levels during pregnancy and early cord clamping at birth than infant feeding.

If you'd like to read more about iron and breastfed babies, check out this great kellymom page.  She does a really good job interpreting primary publications, and has a great reference section.  http://www.kellymom.com/nutrition/vitamins/iron.html

[Courtney-Ostaff]

Thanks for the info!  I was just repeating what my pediatrician told me.  She didn't worry about it, though I read an article in one of those ubiquitous parenting magazines about iron supplementation at 6 months.  When I took my daughter in at six months, she did just fine on her iron levels. I will say that I started my daughter on iron-rich foods, like meat and eggs before six months, so it was never something I worried about.  

I did go visit the webpage, which seems like a great non-official resource. I didn't see anything about their ability to absorb iron decreasing. Neither did I see anywhere about EBF not correlating with a drop in iron after six months.

This might be helpful:

Iron Supplements

Most babies are born with sufficient reserves of iron that will protect them from anemia. If your baby is breastfed, there is sufficient, well-absorbed iron to give her an adequate supply so that no additional supplement is necessary. When she is between four and six months old, you should be starting your breastfed infant on baby foods that contain supplemental iron (cereals, meats, green vegetables), which should further guarantee sufficient iron for proper growth.

If you are bottle-feeding your baby, it is now recommended that you use iron-fortified formula (containing from 4 to 12 mg of iron) from birth through the entire first year of life. Premature babies have fewer iron stores, so they often need additional iron beyond what they receive from breastmilk or formula.  

Last Updated

 

11/17/2010

Source

 

Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics)

Merry Christmas/Kwanzaa/Hannukah/Solstice/etc!!

[ShanaV]

They were tested because we had to go to the ER for IV fluids because they had an AWFUL tummy virus that had them puking and pooping themselves like crazy.  It sucked BIG TIME.  Anyhoo, they did several blood tests while there.  Nightmare.  

[AislinCarys]

Well, the one thing that is clear is that unless the baby was born very small or premature the iron stores should last at least past 6 months. There are very few, and mostly very small, studies (and a huge need for more, and bigger studies!). But, this study was quite large, and well-made:

K.G. Dewey, et al., Iron supplementation affects growth and morbidity of breast-fed infants: results of a randomized trial in Sweden and Honduras
Journal of Nutrition 132, no. 2 (Nov 2002): 3249-55.

http://jn.nutrition.org/cgi/content/full/132/11/3249

Contents: 4-6 month old infants on breastmilk but allowed tastes of vegetables, control group supplemented with iron, result: extra iron un-necessary.


WHO says of this study that it proves exclusive breastfeeding for at least 7 months is safe, and no risk for iron deficiency. (I think the study is a bit too small to make that call):

Siimes MA, Salmenpera L, Perheentupa J. Exclusive breast-feeding for 9 months: risk of iron deficiency. J Pediatr 1984 Feb;104(2):196-9.

http://www.ncbi.nlm.nih.gov/pubmed/6694011

Contents: The study behind WHO's recommendations. 30 breastfed infants compared with 30 on formula. None of the breastfed babies were iron deficient by 7 months. By 9 months 2 or 3 were slightly deficient.


The only other relevant breastfeeding/iron studies are about extended breastfeeding (12 m +).